ArticleDiabetes technology & therapeutics2013
Computerization of the Yale insulin infusion protocol and potential insights into causes of hypoglycemia with intravenous insulin.
Article in Diabetes technology & therapeutics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Advances in the management of hyperglycaemia and diabetes mellitus during hospitalization.Nature reviews. Endocrinology · 2025Review
- Inpatient Insulin Dosing Calculators.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Nursing Perspectives on the Use of Continuous Glucose Monitoring in the Intensive Care Unit.Journal of diabetes science and technology · 2023Article
- A Retrospective Cohort Analysis of Two Computerized Insulin Infusion Protocols.Journal of diabetes science and technology · 2023Article
- Insulin Infusion Computer Calculator Programmed Directly Into Electronic Health Record Medication Administration Record.Journal of diabetes science and technology · 2021Article
- Improving Hospital Glucometrics, Workflow, and Outcomes with a Computerized Intravenous Insulin Dose Calculator Built into the Electronic Health Record.Journal of diabetes science and technology · 2021Article
- Monitoring the Impact of Aggressive Glycemic Intervention during Critical Care after Cardiac Surgery with a Glycemic Expert System for Nurse-Implemented Euglycemia: The MAGIC GENIE Project.Journal of diabetes science and technology · 2021Article
- Optimal Blood Glucose Monitoring Interval for Insulin Infusion in Critically Ill Non-Cardiothoracic Patients: A Pilot Study.Acta bio-medica : Atenei Parmensis · 2021Article
- Review of Intravenous and Subcutaneous Electronic Glucose Management Systems for Inpatient Glycemic Control.Current diabetes reports · 2020Review
- Letter: An Electronic Health Record-Integrated Computerized Intravenous Insulin Infusion Protocol: Clinical Outcomes andDiabetes & metabolism journal · 2020Article
- An Electronic Health Record-Integrated Computerized Intravenous Insulin Infusion Protocol: Clinical Outcomes andDiabetes & metabolism journal · 2020Article
- Article
- Response to Letter Concerning Comparison Between Different Electronic Glucose Management Technologies.Journal of diabetes science and technology · 2019Article
- Glucose Management Technologies for the Critically Ill.Journal of diabetes science and technology · 2019Review
- Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas.Critical care (London, England) · 2018Review
- Hypoglycemia Prevention by Algorithm Design During Intravenous Insulin Infusion.Current diabetes reports · 2018Review
- Hypoglycemia Reduction Strategies in the ICU.Current diabetes reports · 2017Review
- A comparison of two insulin infusion protocols in the medical intensive care unit by continuous glucose monitoring.Annals of intensive care · 2016Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of critically ill hyperglycemic patients in the intensive care unit (ICU) has been fraught with recent controversy. Only one randomized trial has demonstrated a mortality benefit to intensive glycemic control, with all subsequent studies failing to confirm this benefit and revealing a markedly increased risk of severe hypoglycemia (SH) in intensively treated patients. In most of these trials, adherence to the protocols were neither tracked nor reported.
methodsA retrospective analysis of all patients admitted to an ICU who were treated with an insulin infusion directed by the GlucoCare™ IGC System, an FDA-cleared insulin-dosing calculator (Yale 100-140 mg/dL protocol). Mean blood glucose (BG) levels, time to target range and incidence of SH (<40 mg/dL) and moderate hypoglycemia (MH) (40-69 mg/dL) were determined, and potential causes of hypoglycemic episodes were assessed.
resultsMean post-target BG was approximately 123 mg/dL. Of >55,000 readings in 1,657 patients, overall incidence of SH was 0.01% of readings and 0.3% of patients. MH occurred in 1.1% of readings and 17.6% of patients. The top potential causes of MH were: (1) Protocol-directed recommendations including continuation of insulin with BG <100 mg/dL and decreases in the frequency of BG checks (63.7%), and (2) Staff non-adherence to protocol directives (15.3%).
conclusionsThe results of the GlucoCare-directed Yale 100-140 mg/dL protocol experience revealed an extremely low incidence of SH and an incidence of MH of 1.1%. The incidence of SH in this study was lower than the control group of the NICE-SUGAR study and are supportive of the new Society of Critical Care guidelines to target BG levels of 100-150 mg/dL in critically ill patients. Further refinements to the original protocol and emphasis on staff adherence to protocol directives could potentially further reduce these very low hypoglycemia rates.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.